Derivation and External Validation of a Venous Thromboembolism Risk Prediction Model in Patients with Acute Lymphoblastic Leukemia Receiving Asparaginase Therapy

Background: Patients with acute lymphoblastic leukemia (ALL) receiving L-asparaginase (ASP) based induction therapy have a high risk of venous thromboembolism (VTE). Studies investigating universal thromboprophylaxis strategies have yielded sub-optimal results. Risk prediction models are needed to i...

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Published in:Blood 2024-11, Vol.144, p.1250-1250
Main Authors: Anderson, Daniela R, Gangaraju, Radhika, Sedhom, Wafik, Hamulyák, Eva N., Wang, Tzu-Fei, O'Dwyer, Kristen M., Carney, Brian J., Muthiah, Chandrasekar, Liedtke, Michaela, Badar, Talha, Shimony, Shai O., Robinson, Renana, Sanfilippo, Kristen M., Derkach, Andriy, Dinner, Shira N., Biemond, Bart J., Seymour, Kimberly H, Nemirovsky, David, Goldberg, Leah A, Kapadia, Anjani D, Levavi, Hannah, Bar-Natan, Michal, Van Hyfte, Grace, Bansal, Karan, Carrier, Marc, Fulcher, Jill, Gerrits, Anke M, Luger, Selina, Guru Murthy, Guru Subramanian, Luskin, Marlise R., Wolach, Ofir, Shomali, William, Zwicker, Jeffrey I., Stock, Wendy, Leader, Avi
Format: Article
Language:English
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Summary:Background: Patients with acute lymphoblastic leukemia (ALL) receiving L-asparaginase (ASP) based induction therapy have a high risk of venous thromboembolism (VTE). Studies investigating universal thromboprophylaxis strategies have yielded sub-optimal results. Risk prediction models are needed to identify high-risk patients who would be candidates for intensification of thromboprophylaxis, and lower risk patients who are unlikely to benefit. Aims: Derive and externally validate a risk prediction model for VTE in patients with ALL receiving ASP therapy. Methods: We conducted a multicenter, international, cohort study of patients with newly-diagnosed ALL receiving ASP-based induction therapy (≥18yrs). The derivation and external validation cohorts included 306 and 97 patients without VTE prior to ASP therapy, respectively. Patients on therapeutic anticoagulation at index were excluded. Patients were followed from date of first ASP dose for 100 days post ALL diagnosis or until VTE, therapeutic anticoagulation or death. Candidate predictors were documented at ALL diagnosis and included demographics, disease and treatment characteristics, VTE history, comorbidities, thromboprophylaxis, complete blood count, fibrinogen and d-dimer. D-dimer was only analyzed within the 7 derivation cohort centers who routinely tested this at ALL diagnosis with
ISSN:0006-4971
DOI:10.1182/blood-2024-201997